EXERCISES

1. Lip Exercise – Pop-Eye Lips

Pucker lips keeping sealed, Swing lips to the right side, Then the left side. Repeat 10 times. Alternative/Modification: Act like you have a pipe.

2. Lip Exercise – Granny Surprise Face

Roll lips over teeth making an ‘O’ shape, raise your eyebrows and hold the count of 15. Repeat 3 times.

3. Lip Exercise – Lip Closure

Patient is asked to press lips tightly together for 5 s, relax and repeat 5 times.

4. Lip Exercise – Lip Puffer Exercise

This exercise involves forcing the air or liquid in between the upper and lower lips and puffing out the lips to the farthest extension. It should be repeated 5-10 times/day.

5. Lip Exercise – Button pull exercise

A button of 1-1.5 inch diameter is taken, and a thread is passed through the button holes. The patient is asked to place the button behind the lips and pull the thread outwards while resisting it with tight lip seal.

6. Lip Exercise – Forced Lip Closure

Lip exercise involves holding and splashing of water back and forth behind the lips as if done during gargling between the lips until they get tired. The patient is also asked to puff the air behind the lips and cheeks. Patient should not break the lip seal.

7. Lip Exercise – Card Pull Exercise

The “card pull exercise” follows the principle of tug of war, in which the patient holds the card with one hand and tries pulling it. At the same time, the patient tries to holds the card tightly between the upper and lower lips.

8. Lip Exercise – Gum Drop Exercise

Another useful exercise recommended by the dentists is the “gum drop exercise” in which a large size gum drop is taken, approx. 1 ounce. An 18-20 inch string, depending on the height of the patient is taken. One end of the string is attached to the gum drop, and the other end is behind the teeth and held with the lips. The patient is asked to place his/her hands behind the back and to bend forward till the face is parallel with the floor and the string is stretched. Then the patient is asked to open his lips and stretch them as far down as possible, and the same procedure is followed 5-10 times a day.

Myofunctional Exercises for Sleep Apnea

Myofunctional therapy is a set of exercises that aims to restore the orofacial muscles to its normal function. These exercises focus on optimizing tongue strength, orofacial posture and nasal breathing

For maximum effectiveness of therapy perform each recommended exercise at least 5 times per session, five times a day for a period of 3 months or longer

It is recommended to practice these exercises in front of a mirror (while maintaining upright posture and nasal breathing), so it is easier to see what is happening.

Myofunctional therapy is an exercise training programme for the muscles around your face, mouth and tongue. These exercises are designed to improve issues with talking, eating or breathing. Also as support treatment for Sleep-disordered breathing.

1.BREATHING EXERCISES

Nasal breathing: Lips closed, tongue towards (suctioned on) the roof of mouth, Breath only through nose making sure your abdomen expands. (Use Nasal Saline spray)

2. Alternate Nose breathing

Improve and encourage nasal breathing which can help to stabilise airway during sleep

Steps:

1. With mouth closed and jaw relaxed, block right side of your nostril and breathe in and out through the left nostril.
2. Repeat by blocking left side of nostril
3. Determine which nostril id more/less congested
4. Block the nostril that is less congested and breathe in from the more congested nostril for 30 to 60 seconds
5. Repeat on the other nostril

TONGUE EXERCISES

1. Tongue on the spot and swallow

Rest your tongue on the roof of your mouth where your upper inside gums and teeth meet “THE SPOT” bite down so that your back teeth are together, lips closed. The back of your tongue should lightly contact the roof of your mouth, hold your tongue on the spot for 30 seconds and try to swallow, when you swallow, do not let your tongue come off the spot.

2. Tongue Stretch

Tongue pull aerobics consists of 4 parts, touch nose hold for 10 seconds touch chin hold for 10 seconds, Push your tongue to right hold for 10seconds, push your tongue to left hold for 10 seconds (Repeat 10times)

3. Jaw Breaker

Strengthens facial and tongue muscles which can help to stabilise airway during sleep

Steps:

1. Push tip of your tongue into your left cheek and hold for 3 seconds
2. Repeat on right side and repeat 3 times on each side

4. ‘N’ spot

Rest tongue gently on palatal (bumpy) gum tissue behind upper front teeth (the “N” spot), keep teeth lightly separated, make sure lips are sealed and breathing exclusively through nose. Can hum with tip of tongue on “N” spot, now move the tongue to the middle of the upper palate, now to the end of the palate to start to get the sensation of how tongue should lay like a blanket across palatte, Repeat 5 times

Oropharyngeal Exercises

1. Reach for the ceiling

Your trachea will be lifted upward, your throat muscles will contract. All the muscles in the front of your neck are exercised and stretched when the trachea is elevated. Your tongue will remain in a neutral position rather than slipping back inside your throat- and blocking your airway.

Steps:

1. Lift your head as high as you can, looking at the ceiling
2. Stick your tongue out and upward, as though you’re attempting to touch the ceiling with it.
3. Hold the tongue in this position for 10seconds and repeat 5 more times.

2. Uvula raises

Elevate your soft palate and UVULA while saying “A” 20 times

3. Soft palate blowing

The soft palate and uvula are elevated during this exercise. The elevation process is exercising the muscles of your throat. The Pharynx will expand and be enlarged. The respiratory system is also being trained in this exercise.

Steps:

1. Inhale air through your nose, exhale through your mouth while keeping your lips pressed together
2. When you exhale tighten your abdomen
3. Maintain your blowing for 5 seconds
4. Repeat this pattern at least 10 more times and repeat this exercise 4 times daily

4. Tiger Yell

Strengthen all the muscles in the back of your throat

Steps:

1. Open your mouth as wide as possible, and stick your tongue out in a downward position. Your tongue needs to be stuck our as far as possible.
2. The UVULA needs to be lifted upwards as you stick your tongue out.
3. The mirror is used to ensure that you’re lifting the UVULA up correctly. You’ll soon begin to sense that you’ve lifted it and won’t require the mirror
4. Hold the lifted UVULA for 5 seconds and repeat 10 more times.

5. Ceiling swallow

The swallowing action lifts the trachea and the throat muscles contract, exercise and tone

Steps:

1. Bring your head right down so your chin is resting on your chest
2. Open your mouth wide sticking your tongue out as far as possible
3. Gently bite down on your tongue while lifting your head up towards the ceiling
4. When you reach the top, looking up at the ceiling and with your tongue sticking out, you need to swallow and repeat this 5 more times

• Performed for 5 seconds
• Repeated 3 or more times
• Each set should be repeated 2 times a day

Aim

• The aim of myofunctional
• therapy is to retrain and restore orofacial muscles
• It is important to use our orofacial muscles correctly. Failure to do so decreases effectiveness of therapy
• Training of orofacial muscles requires at least 3 months of daily exercises before effectiveness of therapy can be seen

Myofunctional Lip Competency Exercise Videos

Please follow the links below to view the video demonstration of certain lip exercises

1. https://www.youtube.com/watch?v=ByCWx0H-o_U

2. https://www.youtube.com/watch?v=h0DDZ63YqYY

Myofunctional Exercises for Sleep Apnea PDF